Getting Ready for Open Enrollment: What You Need to Know for Next Year

As we approach the open enrollment period for the Health Insurance Marketplace, it’s crucial to stay informed about any changes that could affect your health coverage. This year, more than ever, staying on top of your life circumstances can help you secure the best possible plan. Here are some key life changes to keep in mind and why they matter for your health insurance:

**Pregnancy**

If you or a dependent becomes pregnant, this can significantly impact your health insurance needs. Many Marketplace plans provide coverage for maternity care, which includes prenatal visits, labor and delivery, and postnatal care. Reporting a pregnancy ensures you can access necessary services and potentially qualify for additional benefits or subsidies. It’s essential to update your plan to reflect this change so you can receive the appropriate care without unexpected expenses.

**Income Changes**

Your income is a major factor in determining your eligibility for subsidies and cost-sharing reductions. If you’ve had a raise, a pay cut, or a change in employment status, it's important to report these changes during open enrollment. An increase in income might reduce your subsidy amount, while a decrease could make you eligible for more substantial financial assistance. Accurate reporting ensures you’re paying the correct premium and getting the right level of support. Estimating your income correctly also helps you avoid tax penalties.

**Address Changes**

Moving to a new address can affect your health insurance coverage, as plans and networks can vary by location. When you move, your existing plan might not cover healthcare providers in your new area, necessitating a switch to a plan that does. Reporting an address change during open enrollment allows you to choose a plan that includes doctors and hospitals in your new location, ensuring continuity of care.

**Tax Filing Status**

Your tax filing status can influence your eligibility for certain health insurance subsidies. Changes such as filing jointly after getting married or filing separately can alter your household income calculations and subsidy amounts. Updating this information helps prevent discrepancies that could affect your tax return and avoid any surprises come tax season. Be sure to keep your Marketplace information current to reflect your most accurate tax status.

**Divorce**

A divorce can significantly change your household size and income, impacting your health insurance plan and subsidies. You may need to enroll in a new plan that better suits your new circumstances. Reporting a divorce ensures that your coverage remains appropriate for your current needs and prevents any lapses in coverage that might occur during such transitions.

**Marriage**

Getting married is another life change that can alter your health insurance needs. When you get married, you have the option to combine your health plans or choose a new one that works best for both of you. This might also affect your subsidy eligibility, as household income and size will change. Updating your marital status during open enrollment helps ensure you have the best plan for your new family unit.

**Health Changes**

If you've received a new diagnosis or need a new prescription, your healthcare needs might change significantly. Different plans offer varying levels of coverage for medications and treatments. By reporting these health changes, you can select a plan that provides the necessary coverage for your new health conditions, ensuring you get the care you need without facing prohibitive costs.

At Utah Avenue, we understand that life is full of changes, and we’re here to help you navigate them. If you want to know what your plan benefits and price will be for next year, give us a call! We can make sure that you are the first to know changes in your plan for 2025.

If you're one of our current clients, we want to know all your changes. To make this process easier, our agents will be sending out a survey to gather all relevant changes in your circumstances. This information will enable us to find the best plan for you and your family for 2025. Open enrollment is the perfect time to review and update your health insurance information to reflect any changes in your life. Doing so ensures you have the right coverage and financial assistance, helping you avoid unexpected expenses and access the care you need.

Let’s make this open enrollment period a successful one together! Our team is ready to assist you every step of the way, ensuring you and your family are covered and cared for in the year ahead.